Provider Demographics
NPI:1073809703
Name:MILLER, ANDREW A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:A
Last Name:MILLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 CAPITAL CIR NE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4108
Mailing Address - Country:US
Mailing Address - Phone:850-668-9159
Mailing Address - Fax:850-385-0972
Practice Address - Street 1:2760 CAPITAL CIR NE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4108
Practice Address - Country:US
Practice Address - Phone:850-668-9159
Practice Address - Fax:850-385-0972
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 32851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical